Pneumococcal Disease

What is pneumococcal disease?

Pneumococcal (noo-muh-KOK-uhl) disease is an infection caused by bacteria called Streptococcus pneumoniae (also known as pneumococcus). It’s contagious and may cause severe illness, so early diagnosis and treatment is important.

Pneumococcal disease can affect many different systems in your body. It may result in conditions with mild symptoms like a sinus infection (sinusitis). But it can also lead to pneumonia, blood infection (sepsis) or bacterial meningitis — and may be life-threatening at any age.

Treatment typically involves antibiotics. Vaccines can reduce the risk of infection, especially in young children and older adults. Talk to a healthcare provider about the immunizations that are appropriate for you and your family.

What is the difference between pneumonia and pneumococcal disease?

Pneumococcal disease is the name for any infection caused by pneumococcus. One of the pneumococcal diseases is pneumococcal pneumonia. It’s the most common, severe type of pneumococcal disease.

There are other causes of pneumonia besides pneumococcus. Other bacteria and viruses, along with fungi, can also cause pneumonia. So not every case of pneumonia is pneumococcal pneumonia.

What are the types of pneumococcal disease?

Scientists have identified about 100 strains of Streptococcus pneumoniae. They cause two main types of pneumococcal disease:

• Noninvasive: This type of infection is more common, less serious, and doesn’t spread to infect major organs or your blood.
• Invasive: This more severe type occurs in your blood, in an area of your body that shouldn’t have bacteria normally (like bone or your brain) or in a major organ like your lungs.

What conditions does pneumococcal disease cause?

Pneumococcus causes many infections that can be almost anywhere in your body. The most severe (and potentially life-threatening) invasive illnesses have different symptoms but involve the same bacteria. These require urgent medical treatment and include:

• Blood infection (bacteremia).
• Brain and spinal cord membrane (lining) infection (bacterial meningitis).
• Lung infection (pneumonia).
• Bone infection (osteomyelitis).
• Joint infection (septic arthritis).
• Widespread inflammation of tissues and organs (sepsis), as a reaction to septicemia (bacteria in the blood).

Pneumococcal meningitis and bacteremia can result in severe disabilities, like brain damage, hearing loss or surgical limb removal (amputation). It can also be fatal if untreated.

Less serious illnesses that pneumococcus can cause include:

• Airway inflammation (bronchitis).
• Middle ear infection (otitis media).
• Pink eye (conjunctivitis).
• Sinus infection (sinusitis).

Who might get pneumococcal disease?

Anyone can develop pneumococcal disease. Children younger than 2 are more likely to develop an infection, along with children who have:

• Cochlear implants.
• A cerebrospinal fluid (CSF) leak.
• Diabetes.
• Kidney disorders, such as nephrotic syndrome.
• Sickle cell disease, or damaged or removed spleens.
• Weakened immune systems due to medication, solid organ transplants or conditions such as cancer or HIV/AIDS.

Adults with weakened immune systems also face a higher risk of developing pneumococcal disease, as well as those who:

• Are age 65 or older.
• Have alcohol use disorder.
• Have a cerebrospinal fluid (CSF) leak.
• Have chronic (long-term) lung disease, cardiovascular disease, liver disease or kidney disease.
• Smoke cigarettes.
• Have cochlear implants.

The time of year can make a difference, too. You’re more likely to develop pneumococcal disease in the cooler, drier months.

How common is pneumococcal disease?

Pneumococcal disease is relatively common. According to the Centers for Disease Control and Prevention (CDC), each year, pneumococcal disease:

• Causes about 2,000 cases of pneumococcal meningitis.
• Hospitalizes more than 150,000 people with pneumococcal pneumonia.

Pneumococcal pneumonia is the disease that Streptococcus pneumoniae most often causes. While viruses cause most childhood pneumonia, pneumococcus is the most common bacterial cause of childhood pneumonia.

Is pneumococcal disease contagious?

Many people, especially children, carry Streptococcus pneumoniae bacteria in their noses and throats. It’s usually spread through droplets of saliva or mucus, even if you don’t have symptoms.

Most of the time, this doesn’t result in illness. But if you carry the bacteria (are a carrier), you can potentially give the infection to someone else through droplets of saliva or mucus when you:

• Cough.
• Sneeze.
• Touch each other, share objects or kiss.

Because many people have pneumococcal bacteria living in them without causing disease, it’s very hard to know when pneumococcus is most contagious. Once you begin treatment for pneumococcal infection, you likely won’t be contagious after a day or two.

What causes pneumococcal disease?

Streptococcus pneumoniae bacteria cause pneumococcal disease. These bacteria are often found in the noses and throats of healthy people, especially children. Illness develops when the bacteria spread and set up infection in your body.

What are the symptoms of pneumococcal disease?

Symptoms of pneumococcal disease vary based on the location and severity of the infection.

In the case of mild infections, you may experience pain, fever or swelling of your affected body part:

• Signs and symptoms of middle ear infection caused by pneumococcal bacteria include infection behind the ear drum, pain and fatigue.
• Sinus infections may lead to nasal congestion, headache or loss of sense of smell (anosmia).

Pneumococcal disease can also lead to life-threatening complications.

In the case of pneumonia, you may have:

• Chest pain.
• Cough.
• Difficulty breathing.
• Fever or chills.

Symptoms of meningitis often include:

• Fever.
• Headache.
• Low appetite, poor drinking or vomiting in babies.
• Sensitivity to light.

If you have bacteremia, you may experience:

• Chills.
• Fever.
• Confusion.

You may develop an extreme inflammatory response to pneumococcal infection. Known as sepsis, these symptoms include:

• Confusion.
• Difficulty breathing or shortness of breath (dyspnea).
• Extreme discomfort or pain.
• Fever or chills.
• Rapid heart rate.
• Sweating.
• Death if not treated quickly.

Talk to your healthcare provider about your symptoms. Call 911 immediately if you or your child experiences a fever over 100.5 degrees Fahrenheit (38.06 degrees Celsius), chest pain or difficulty breathing.

How is pneumococcal disease diagnosed?

Healthcare providers test for Streptococcus pneumoniae to diagnose pneumococcal disease and rule out other conditions. Your healthcare provider does a physical exam and asks you about your medical history and current symptoms.

Your provider may use tests such as:

• Blood test (complete blood count or CBC).
• Urine test (urinalysis).
• Phlegm test.
• Chest X-ray.
• Spinal tap (lumbar puncture).

Is there a cure for pneumococcal disease?

Early diagnosis and treatment with antibiotics can treat most pneumococcal infections. The length of time needed for treatment and the type of antibiotic may be different depending on where the infection is or how serious the infection is. Severe infection may sometimes result in chronic (long-term) illness, disability or death.

Is pneumococcal disease life-threatening?

Many pneumococcal infections are mild, but the bacteria can cause serious and potentially fatal disease. Without prompt diagnosis and treatment, it may be life-threatening. Be sure to see your provider if you develop concerning symptoms and follow care instructions so you recover well.

What is the treatment for pneumococcal disease?

Healthcare providers typically use antibiotics to treat bacterial infections such as pneumococcal disease. Your provider may have to try several antibiotics because the bacteria have become resistant to certain medications (this means some medications no longer kill the bacteria).

For mild infections, your healthcare provider may also recommend:

• Fluids.
• Pain relievers.
• Rest.

In severe cases, such as meningitis, you may need to stay in the hospital for treatment.

How can I reduce my risk of developing pneumococcal disease?

Getting vaccinated is the most effective way to reduce your risk of developing pneumococcal disease. Vaccines are currently recommended for:

• Children younger than 2. (It’s currently part of the standard immunization schedule for babies and children in the United States).
• Children and adults with other chronic diseases and immune deficiencies that make them more susceptible to pneumococcal infections.
• Adults 65 and older.
• People between 19 and 64 who have certain medical conditions or other risk factors.
• People who live or work in a nursing home or other long-term care facilities.

Talk to a healthcare provider about the appropriate vaccine and its timing for you or your child. You should receive the flu vaccine during the appropriate season. You can get both vaccines at the same time.

Are pneumococcal vaccines safe?

Pneumococcal vaccines are safe and don’t cause pneumococcal disease. Side effects are uncommon, typically mild and should go away within two days. They may include pain, swelling or tenderness where you received the shot. Rarely, you experience symptoms like muscle aches, joint pain or fever. Ask your provider any questions you may have about vaccine safety.

How long does it take to recover from pneumococcal disease?

Recovery from pneumococcal disease depends on the type of infection and its severity. In mild cases, you begin to feel better shortly after starting antibiotic treatment. Less commonly, serious infection may result in chronic (long-term) illness or disability.

Can I get pneumococcal disease more than once?

Developing pneumococcal disease once doesn’t protect you from getting it again. Vaccination is very effective, and the best way to avoid the disease, though vaccines can’t provide 100% protection.

Should I take antibiotics to prevent sickness?

Only take antibiotics if your provider prescribes them, and always finish the entire course. Most people don’t develop the disease after exposure to someone with an infection.

A note from Cleveland Clinic

Pneumococcal disease can sound scarier than it is. Early diagnosis and antibiotics help you get better, and usually ensure that you don’t get severe complications. See your healthcare provider if you start having worrisome symptoms so you can get treatment right away. You can also protect yourself and your loved ones from pneumococcal disease by taking one important step — getting the pneumococcal vaccine. Ask a healthcare provider about how vaccination can keep you and your loved ones healthy and safe.